Individual
DERROL MARVIN SILLITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5511 112TH AVE E, SUITE B, PUYALLUP, WA 98372
(253) 845-4655
(253) 845-1052
Mailing address
5511 112TH AVE E, SUITE B, PUYALLUP, WA 98372
(253) 845-4655
(253) 845-1052
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1192
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SI3427
REGENCE BLUE SHIELD
WA
Enumeration date
07/20/2005
Last updated
07/08/2007
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